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Objective: The currently available cardiac biomarkers are not sufficient to differentiate between myocardial infarction with non-obstructive coronary arteries (MINOCA) and acute coronary syndrome (ACS) without the use of coronary angiography. In this context, this study aimed to evaluate inducible nitric oxide synthase (iNOS) activity as a potential marker for the differential diagnosis of MINOCA and ACS. Method: The study population comprised 734 consecutive patients who presented to our hospital with chest pain between July 2022 and January 2023. Leftover plasma samples collected in EDTA vials were sent for troponin T estimation within 24 hours of the onset of chest pain. Patients’ blood samples were collected into tubes for malondialdehyde (MDA), iNOS, and total sialic acid (TSA) measurements and centrifuged at 4000 g, 4 °C for 10 min, and the sera obtained as a result were kept at -25 °C until the analyses were performed. Results: The mean age of the study population, which consisted of 648 patients [421 (65.6%) males, was 62±12] years. There were no significant difference between the MINOCA and ACS patients in MDA and homocysteine levels. Univariate logistic regression analysis revealed significant correlations between gender, age, diabetes mellitus (DM), glucose, urea, iNOS, smoking, hemoglobin, platelets, lymphocytes, monocytes, neutrophils, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, creatine, and TSA as significant predictors of MINOCA. Further analysis of these variables using multivariate logistic regression revealed that sex, age, presence of DM, glucose and urea levels, and iNOS were independent predictors of MINOCA. The iNOS level was significantly higher in patients with MINOCA than in those with ACS. The optimal iNOS cut-off value of >1372.9 pg/mL predicted MINOCA with 99.4% sensitivity and 93.7% specificity (area under the curve: 0.99, 95% confidence interval: 0.979-0.996, p

Due to their thermal performance, domed roofs are one of the passive solutions that affect energy consumption in buildings. The thermal performance of domed roofs has been investigated in many naturally ventilated spaces. However, few studies have discussed their performance in conditioned spaces. Therefore, this study introduces a computational comparison between domed and flat roofs to investigate their impact on thermal comfort inside a conditioned mosque. At an earlier stage, field measurements were carried out inside a Bahraini mosque to acquire its indoor air conditions during the summer period of 2021, in addition to validating the computational model. The findings of this study confirm that, under mechanical cooling conditions, the flat roof offers a lower indoor temperature than the domed roof by 0.4 °C and 0.1 °C for open and closed doors, respectively. Similarly, the air velocity is lower by approximately 0.01 m/s for both door modes. The overall PMV values of the flat roof are also lower by 0.07 and 0.01, while the PPD values are lower by 0.20, and 0.34 for open and closed doors, respectively. Based on these small differences, it can be concluded that the thermal performance of both roofing systems behaves equally in conditioned spaces. However, the air patterns are substantially different, the overall thermal performance is similar. This similarity drives building designers to rethink the thermal performance of the domed roofs in air-conditioned spaces with such a hot climate, regardless of their aesthetic and acoustical behaviour.

Resumo Fundamento: A isquemia com artéria coronária não obstrutiva (INOCA) é uma doença cardíaca isquêmica que inclui principalmente disfunção microvascular coronariana e/ou vasoespasmo coronariano epicárdico devido à disfunção vascular coronariana subjacente e pode ser observada mais comumente em pacientes do sexo feminino. O índice de inflamação imunológica sistêmica (SII, relação plaquetas × neutrófilos/linfócitos) é um novo marcador que prediz resultados clínicos adversos na doença arterial coronariana (DAC). Objetivo: Este estudo tem como objetivo investigar a relação entre INOCA e SII, um novo marcador associado à inflamação. Métodos: Um total de 424 pacientes (212 pacientes com INOCA e 212 controles normais) foram incluídos no estudo. Amostras de sangue venoso periférico foram recebidas de toda a população do estudo antes da angiografia coronária para medir o SII e outros parâmetros hematológicos. Em nosso estudo o valor de p

Background: Heart failure with preserved ejection fraction is a complex and heterogeneous clinical syndrome, poses significant diagnostic challenges. The HFA-PEFF [Heart Failure Association of ESC diagnostic algorithm, P (Pretest Assessment), E (Echocardiographic and Natriuretic Peptide score), F1 (Functional testing in Case of Uncertainty), F2 (Final Aetiology)] and H2FPEF [Heavy (BMI>30 kg/m2), Hypertensive (use of ≥2 antihypertensive medications), atrial Fibrillation (paroxysmal or persistent), Pulmonary hypertension (Doppler Echocardiographic estimated Pulmonary Artery Systolic Pressure >35 mm Hg), Elderly (age >60 years), Filling pressure (Doppler Echocardiographic E/e' >9)] scoring systems were developed to aid in diagnosing heart failure with preserved ejection fraction. This study aimed to assess the concordance and clinical accuracy of these scoring systems in the 'A comPrehensive, ObservationaL registry of heart faiLure with mildly reduced and preserved ejection fractiON' cohort. Methods: A comPrehensive, ObservationaL registry of heart faiLure with mildly reduced and preserved ejection fractiON study was conducted as a multicenter, cross-sectional, and observational study; to evaluate a group of Heart failure with mildly reduced ejection fraction and heart failure with preserved ejection fraction patients who were seen by cardiologists in 13 participating centers across 12 cities in Türkiye. Results: The study enrolled 819 patients with heart failure with preserved ejection fraction, with high probability heart failure with preserved ejection fraction rates of 40% and 26% for HFA-PEFF and H2FPEF scorings, respectively. The concordance between the 2 scoring systems was found to be low (Kendall's taub correlation coefficient of 0.242, P

Abstract Although hypertension is considered high intravascular pressure, impairing circadian blood pressure (BP) has been shown to potentially contribute to poor clinical outcomes. Systemic immune‐inflammation index (SII), based on platelet, neutrophil, and lymphocyte counts, has been established as a strong prognostic marker in cardiovascular disease. The role of inflammation in the pathogenesis of hypertension is a well‐known issue and inflammatory markers are associated with BP variability. We aimed to investigate whether there is a relationship between circadian BP changes and SII in newly diagnosed hypertensive patients. The study population consisted of 196 newly diagnosed hypertensive patients without LVH. In total, 76 (38%) patients had a dipper BP pattern, 60 (31%) patients had a non‐dipper BP pattern, and 60 (31%) patients had a reverse‐dipper BP pattern. SII was calculated according to Multivariate logistic regression analysis revealed SII and HDL‐C as an independent predictors of reverse‐dipper circadian pattern in newly diagnosed hypertensive patients. The cut‐off value of the SII for reverse‐dipper hypertension in a ROC curve analysis was >639.73 with 63.3% sensitivity and 84.2% specificity. Our study showed that the SII level was higher in the reverse‐dipper hypertension patient group than in the dipper and non‐dipper hypertension groups. Furthermore, SII was an independent predictor of newly diagnosed reverse‐dipper hypertensive patients. The high SII value in newly diagnosed hypertensive patients can be used as an early warning parameter to identify reverse‐dipper hypertension patients.

Background and Aim:The systemic immune-inflammation index (SII) has been identified as a novel prognostic marker in various illnesses. We investigated the relationship between SII and mortality in patients undergoing primary percutaneous coronary intervention (pPCI). In addition, we planned to examine how SII correlated with SYNTAX II and thrombolysis in myocardial infarction (TIMI) risk scores in this population.Materials and Methods:This retrospective observational study included patients with ST-segment elevation myocardial infarction who underwent pPCI. The endpoint was 1 year all-cause mortality. SII [(neutrophil x platelet)/lymphocyte] was calculated from admission blood samples. Besides clinical and laboratory findings, SII, Syntax II and TIMI risk scores were compared between survivors and non-survivors. The correlation between SII and Syntax II and TIMI risk scores was also evaluated.Results:The study included 334 patients (82.3% male). In the 1 year follow-up, 18 patients (5.4%) died. The SII, Syntax II, and TIMI risk scores were significantly higher in non-survivors than in survivors [mean (standard deviation: SD), 2423 (2005) vs 1686 (998), P = 0.005; median (interquartile range) 43 (35-53) vs 30 (25-37), P < 0.001; and 4 (2-5) vs 2 (1-3), P = 0.005, respectively]. Furthermore, the Syntax II score, TIMI risk score, and SII was independent predictors of 1 year all-cause mortality. SII showed a significant correlation with Syntax II and TIMI risk scores (R2 = 0.28, P = 0.001 and R2 = 0.37, P < 0.001, respectively).Conclusion:SII might provide additional prognostic data alongside Syntax II and TIMI risk scores in patients undergoing pPCI.

Background: The recent 2019 European Society of Cardiology/European Atherosclerosis Society practice guidelines introduced a new risk categorization for patients with diabetes. We aimed to compare the implications of the 2016 and 2019 European Society of Cardiology/European Atherosclerosis Society guidelines with regard to the lipid-lowering treatment use, low-density lipoprotein cholesterol goal attainment rates, and the estimated proportion of patients who would be at goal in an ideal setting. Methods: Patients with diabetes were classified into 4 risk categories according to 2019 European Society of Cardiology/European Atherosclerosis Society dyslipidemia guidelines from the database of EPHESUS (cross-sectional, observational, countrywide registry of cardiology outpatient clinics) study. The use of lipid-lowering treatment and low-density lipoprotein cholesterol goal attainment rates were then compared according to previous and new guidelines. Results: This analysis included a total of 873 diabetic adults. Half of the study population (53.8%) were on lipid-lowering treatment and almost one-fifth (19.1%) were on high-intensity statins. While low-density lipoprotein cholesterol goal was achieved in 19.5% and 7.5% of patients, 87.4% and 69.6% would be on target if their lipid-lowering treatment was intensified according to 2016 and 2019 European Society of Cardiology/European Atherosclerosis Society lipid guidelines, respectively. The new target

Using the tracer gas technique, ventilation rates were estimated in an air-conditioned mosque located in Bahrain. Exhaled CO2 concentrations were traced for different occupancy levels and periods, i.e., 20–200 worshippers during ½ h, 1-h, and 2-h periods. The three known methods of tracer gas technique, namely build-up, steady-state, and decay methods, were examined with reference to measured ventilation rates. In addition to investigating the impact of ventilation rates and operating schedules on the cooling energy consumed. A ½ h occupancy showed a poor correlation between exhaled CO2 concentration and occupancy level, which means it misleads estimating ventilation rates in mosques. In contrast, the 1-h and 2-h occupancy periods showed a strong correlation. The steady-state method overestimated ventilation rates by 10%, while the build-up and decay methods showed 58% and 68%, respectively. Using the 5-prayers operating schedule instead of the on-24-hours schedule reduced the cooling energy consumed by 8%.

Purpose: The aim of our study was to determine whether the RS time measured on an electrocardiogram is associated with the severity of chronic obstructive pulmonary disease (COPD). Materials and Methods: The study population was made up of 100 COPD patients with a mean age of 63 ± 10 years (86% were males). These patients were divided into the mild and moderate COPD (GOLD 1–2) group (n = 45) and the severe and very severe COPD (GOLD 3–4) group (n = 55) according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages. These groups were compared with each other. Results: Heart rate, P wave axis, QRS axis, RS time, and incidence of right bundle branch block were significantly higher in patients with severe and very severe COPD. In the multivariable analysis, heart rate, P wave axis, and RS time (odds ratio = 1.081) were the independent predictors of severe and very severe COPD. The receiver operating characteristic curve analysis showed that the best RS time cutoff value for the prediction of severe and very severe COPD was 60 ms, with a sensitivity of 69.1% and a specificity of 66.7%. Conclusion: RS time simply measured on an electrocardiogram may be a useful screening test for the quick estimation of patients with severe and very severe COPD.

Objective: The aim of this study was to assess the clinical characteristics of patients with heart failure and preserved ejection fraction (HFpEF) and atrial fibrillation (AF) and compare them with those of HFpEF patients without AF. Methods: This study was a sub-group analysis of a multicenter, observational, and cross-sectional registry conducted in Turkey (ClinicalTrials.gov identifier: NCT03026114). Patients with HFpEF were divided into 2 groups: HFpEF with AF and HFpEF with sinus rhythm (SR), and the clinical characteristics of the groups were compared. Results: In a total of 819 HFpEF patients (median age: 67 years; 58% women), 313 (38.2%) had AF. Compared to the patients with SR, those with AF were older (70 years vs 66 years; p

Abstract The question of unity of existence is one of the most fundamental mystical and philosophical issues that is discussed in this article, based on Allāmah Dawānī and Mullah Sadrā’s theoretical foundations. Allāmah Dawānī’s explanation of the question of individual unity is based on principles such as unity of existence, the attribution of essence to existence, the principle of disposition and non-confusion of creatures to the origin of derivation in the sense that the truth of existence is unique in divine essence and the rest is ascribed to the existence. BY investigating Dawānī’s basics, one should say that believing in individual unity of existence is in contrast with his basic principles. The issue is not acceptable in his thought system because by declaring both originality of existence and originality of essence to explain plurality of the universe, belief in redundancy and the relation of essences with existence and declaring disposition has basic inconsistency and internal conflict. The issue is concluded in Mullah Sadrā’s approach because he introduces existence as an objective identity with multiple orders, orders that are only the manifestation of existence and regarding the intensity of the actuality of the origin of existence which encompasses all achievements, there is no room for other affairs. Any creature is a status of statuses of that absolute existence and plurality is nothing but the manifestation of its attributes in the opportunity of names. The explanation is well acceptable with the Mullah Sadrā’s theory of gradation. From what has been stated, it follows that individual unity presented by the two philosophers only have one point in common which is that in the universe there is only one original truth; however their basic principles and manner of explanation are different. The philosophical foundations and principles that cause internal conflict of the discussion for Dawānī and transition from philosophy to mysticism for Mullah Sadrā. The summary of Mullah Sadrā' s theory as an independent theory can be brought up in this sense that in Mullah Sadrā’s views, where he considers the "essence status" of self-existence, individual unity of unconditional type is a divider that from mystical view is interpreted as "absolute identity" and "the essence of oneness". In this approach, there is nothing opposite or contrary to it and all are the emergence and manifestation of that. Existence of God is the individual one truth. But in some cases Mullah Sadrā speaks of unconditional divided existence by looking at God's "action" not His essence which is equal to the term "expanded grace" in mysticism. In this order, predication and generality are tried so that all determinations are present in that.

Objective: Few studies have directly assessed suboptimal management of dyslipidemia in Turkey. This study was conducted to assess patients' understanding and perceptions of high cholesterol as well as physicians' knowledge and awareness of lipid management strategies. Methods: This was a multicenter, observational study (ClinicalTrials.gov identifier: NCT02608645). Consecutive patients admitted to the participating cardiology clinics who were at least 18 years of age and who had been classified in a secondary prevention (SP) group or a high-risk primary prevention (PP) group were enrolled. The study population included 1868 patients from 40 sites in Turkey. Two-thirds (67.5%) of the patients in the SP group had been prescribed a statin, whereas only 30.1% of the PP group patients received statin therapy (p

Introduction: The present study aimed to evaluate the potential utility of thrombosis in myocardial infarction (TIMI) risk index (TRI) for the prediction of stent thrombosis (ST) in ST elevation myocardial infarction (STEMI) patients who were treated with primary percutaneous coronary intervention (pPCI). Methods: This retrospective study was related to the clinical data of 1275 consecutive STEMI patients who underwent pPCI from January 2013 to January 2018. The TRI was calculated for each patient, and the following equation was used; TRI = heart rate x [age/10]2/systolic blood pressure. For the definition of ST, the criteria as proposed by the Academic Research Consortium were applied. Results: The incidence of ST was 3.2% (n=42 patients) in the study. The median value of the TRI was significantly elevated in patients with ST compared to those without ST (22 [17-32] vs. 16 [11-21], P

Background: Clinical characteristics of patients with heart failure may vary geographically. However, limited data are available regarding the geographical differences of patients with heart failure and preserved ejection fraction. Aims: The present subgroup analysis aims to investigate the geographical differences in clinical characteristics, management, and primary etiology of patients with heart failure and preserved ejection fraction in Turkey. Study Design: A cross-sectional study. Methods: A comPrehensive, ObservationaL registry of heart faiLure with mid-range and preserved ejection fractiON (APOLLON) is a multicenter and observational study conducted in seven regions of Turkey (NCT03026114). The present study is a post-hoc analysis of the APOLLON registry. In this substudy, we compared the clinical characteristics of 819 consecutive patients with heart failure and preserved ejection fraction (mean age, 67 years; 57.8% women) admitted to cardiology outpatient units in different geographical regions. Results: Based on the geographical distribution of the entire Turkish population, the highest number of patients enrolled were from Marmara (271 patients, 33.1%). All demographical characteristics, clinical and laboratory findings, comorbidities, primary etiology, and medications prescribed were significantly different between the regions. Furthermore, inter-regional gender differences were identified. Comparatively, the Aegean and Mediterranean regions had older patients with heart failure and preserved ejection fraction (p

Introduction: Stent restenosis remains a clinical challenge for patients with ischemic heart disease, since it is associated with repeated coronary interventions as well as higher hospitalization rates and medical costs. Inflammation plays a significant role. Although an association between stent restenosis, increased C-reactive protein (CRP) and decreased albumin levels has been previously reported, no studies have investigated the ability of the CRP/albumin ratio to predict stent restenosis. Methods: This retrospective study included 448 patients who had previously undergone primary percutaneous coronary intervention and who were referred for subsequent reintervention due to recurrence of anginal symptoms. The study population was divided into two groups based on whether the patient had developed stent restenosis. They were then stratified into three groups according to their CRP/albumin ratio. Results: Out of 448 patients, stent restenosis was observed in 24.5% (n=110), as determined by coronary angiography. Patients with stent restenosis had a higher CRP/albumin ratio, greater platelet distribution width (PDW), higher CRP levels, and lower levels of both high-density lipoprotein (HDL) cholesterol and serum albumin. The CRP/albumin ratio (OR: 2.289, 95% CI: 1.056-4.959; p=0.036), stent diameter, PDW and HDL cholesterol levels were found to be independent predictors of stent restenosis. A ROC curve comparison demonstrated that the CRP/albumin ratio was a better predictor of restenosis than either albumin and CRP individually, but it was not better than PDW and HDL cholesterol. Conclusion: As a novel inflammation-based risk score, the CRP/albumin ratio may be an easily accessible marker for assessment of stent restenosis risk. Resumo: Objetivo: A reestenose de stent permanece como um desafio clínico em doentes com cardiopatia isquémica. A reestenose de stent está associada a intervenções coronárias recorrentes bem como a aumento de internamentos e de custos médicos. A inflamação tem um papel significativo. Embora a associação entre reestenose de stent e o aumento dos níveis de proteína C-reativa (PCR) e a diminuição dos níveis de albumina tenham sido previamente registados, nenhum estudo pesquisou a possibilidade da PCR/albumina prever um diagnóstico de reestenose de stent. Métodos: Este estudo retrospetivo incluiu 448 doentes que tinham sido previamente submetidos a intervenção coronária percutânea primária e que foram referidos para reintervenção posterior devido a ressurgimento dos sintomas de angina. A população do estudo foi dividida em dois grupos com base no facto do doente ter desenvolvido reestenose de stent. Posteriormente, foram estratificados em três grupos de acordo com as relações PCR/albumina. Resultados: De um grupo de 448 doentes, a reestenose de stent foi observada em 24,5% (n = 110), conforme determinado por avaliação através de angiografia coronária. Os doentes com reestenose de stent apresentaram uma relação PCR/albumina mais elevada, variação maior do diâmetro das plaquetas (DP), níveis mais elevados de PCR e níveis mais baixos de colesterol de lipoproteínas de alta densidade (HDL) e de albumina sérica. Os níveis da relação PCR/albumina (OR: 2,289, IC 95%:1,056 – 4,959; p = 0,036), o diâmetro do stent, a variação maior do DP e o colesterol HDL foram considerados fatores preditores independentes da restenose de stent. A comparação das curvas ROC demonstrou que a relação PCR/albumina constituiu um fator preditor melhor do que a albumina e a PCR, isoladamente, não sendo, no entanto, melhor do que o DP e o colesterol HDL. Conclusão: Como novo score de risco baseado em inflamação, a relação PCR/albumina pode ser um marcador facilmente acessível para a avaliação do risco de reestenose de stent. Keywords: Stent restenosis, C-reactive protein/albumin ratio, ST-segment elevation myocardial infarction, Inflammation, Palavras chave: Reestenose de stent, Proteína C reativa/albumina, Enfarte do miocárdio com elevação do segmento ST, Inflamação

Background: Different arterial segments throughout the vascular system develop similar grades of atherosclerosis concomitantly. Urethral ischemia has been proposed as a cause of urethral stricture. Therefore, we aimed to investigate the relationship between coronary artery disease severity using a SYNTAX score and urethral stricture occurrence after urethral catheterization in patients with non–ST-segment-elevation acute coronary syndrome (ACS). Methods: This retrospective study consisted of 306 men with urethral catheters that were diagnosed with ACS and underwent coronary angiography between January 2016 and January 2018 in Kars Kafkas University and Osmaniye Government Hospital, Turkey. Hospital records were reviewed to collect the follow-up data of the patients regarding the occurrence of urethral stricture after urethral catheterization. The study population was divided into 2 groups according to urethral stricture development, and both groups were compared statistically. Results: SYNTAX scores were significantly higher in patients with urethral stricture than in those without urethral stricture (14.86±7.11 vs. 29.25±9.79; P

This study was conducted to investigate the effects of branched chain amino acids (BCAAs) consumption on myocardium and coronary arteries, in rats subjected to regular and intense exercise. Eight-week old, 30 male rats were randomly divided into experimental- and controlgroups. For a total of 8 weeks, every other day, both groups were subjected to a ladder-climbing exercise on a 1.5 m long ladder, with 2.5 cm steps interval, at 70 degrees angle. The experimental group, besides the standard diet, was additionally fed BCAA-supplement at a dose of 1.5 mg/g/day. This study showed that, the experimental group had more frequent atherosclerotic lesions compared to the control group (61.5% vs. 21.4%; p=0.034). Although creatine kinase was similar between the groups, creatine kinase - myocardial band isoform (CK-MB) was significantly higher in the experimental group compared both to control and baseline levels. This is the first study that examines the effects of consuming BCAA supplements on myocardium and coronary arteries in rats subjected to prolonged exercise. We demonstrated that continuous and long-term consumption of BCAA supplement in endurance exercises was associated with coronary atherosclerotic process and myocardial injury.

Objective: A wide gap exists between dyslipidemia guidelines and their implementation in the real world, which is primarily attributed to physician and patient compliance. The aim of this study is to determine physician and patient adherence to dyslipidemia guidelines and various influential factors. Methods: The Evaluation of Perceptions, Knowledge, and Compliance with the Guidelines in Real Life Practice: A Survey on the Under-treatment of Hypercholesterolemia (EPHESUS) trial (ClinicalTrials.gov number NCT02608645) will be an observational, multicenter, non-interventional study. The study targets enrollment of 2000 patients from 50 locations across Turkey. All of the data will be collected in a single visit and current clinical practice will be evaluated. A cross-sectional survey of public perception and knowledge of cholesterol treatment among Turkish adults will be performed. All consecutive patients admitted to cardiology clinics who are in the secondary prevention group (coronary heart disease, peripheral artery disease, atherosclerotic cerebrovascular disease) and who are in the high-risk primary prevention group (type 2 diabetes mellitus with no prior known coronary heart disease; patients who had markedly elevated single risk factors, in particular, cholesterol >8 mmol/L [>310 mg/dL], blood pressure ≥180/110 mmHg, a calculated Systematic Coronary Risk Evaluation [SCORE] ≥5%, or

In Mulla Sadra's philosophical system, human being enjoys a specific stance. He is the only contingent being with existential degrees corresponding and conforming to existential degrees and worlds. Mulla Sadra's environmental philosophy can be regarded as based on the principles and rules founding the system, including fundamentality and gradation of existence, particularly the principles of substantial motion and union of the knower and the known, as well as the stages of creation of soul and its relation with body. Such a philosophy can help us to provide ways to explain the relationship between man and nature, according to which environmental crises occurred to the nature can be managed. In the philosophical system of transcendent theosophy, nature is the manifestation and disclosure of a being continually influencing it in its creation and duration, endowed with knowledge, apprehension and consciousness according to its share in the being, and represents the hidden interior and exterior aspects of reality of existence. Therefore, man's interaction with nature as a living thing is totally different from that which is defined in environmental philosophy based on West's philosophy, which believes in an existential unity between man and nature. The present paper seeks to explain and analyze the meaning of man and nature in Mulla Sadra's philosophy and elaborate on their interrelation.

This study was aimed to explore differences between day and night feeding of farmed European eels (Anguilla anguilla) on: (1) the growth and feeding behaviour of eels; and (2) the subsequent impact on the quality of the culture water. A 30 day field experiment was conducted in which 40 European eels (186.4 ± 9.26 g) were arbitrarily allocated into two replicate concrete ponds (200 x 100 x 125cm) that were divided into two treatment groups, one receiving feed by day (DF) and the other receiving feed at night (NF). Results revealed a significant improvement in eel's growth performance (larger final weight and faster growth) of the fish that were fed by night (NF). Moreover, feeding behaviour was also improved in the NF group with a significantly shorter latency to start feeding and shorter feeding duration. As a consequence of improved feeding behaviour, more favourable water quality conditions (higher dissolved oxygen concentrations and lower ammonia concentrations) were observed in the NF group. In conclusion, feeding eels by night could considerably enhance the culturing of eels by promoting enhanced growth and feeding behavior, and simultaneously improving water quality. Key words: feeding regime; European eel; behaviour; nocturnal feeding; growth; performance

Metal complexes derived from the reaction of Cu(II), Co(II), Ni(II) and Zn(II) acetates and (E)-4-(2-hydroxyphenylimino)pentan-2-one (H2L) have been synthesized and characterized by elemental analyses, MS, IR, UV-Vis., 1H NMR, thermal analyses (TGA and DTG) and magnetic measurements. In all complexes except for Zn(II) complex, the Schiff base ligand acts as a mono-negative tridentate (NOO) donor, through the azomethine nitrogen, the hydroxyl oxygen and the enolic carbonyl oxygen. The structure of the Cu(II) complex is square-planar, the Co(II) is octahedral while, the Ni(II) and Zn(II) are tetrahedral. The optical band gap measurements indicated a semi-conducting nature of these complexes. The biological activities have been screened against two bacteria and two fungi. Some of the studied complexes showed activity against bacteria and fungi.

Background. We aimed to investigate the effects of continuous positive airway pressure (CPAP) treatment on electrocardiography (ECG), premature ventricular contraction load on 24-hour Holter recordings, and implantable cardioverter defibrillator (ICD) shocks in patients with obstructive sleep apnea syndrome (OSAS) and heart failure. Methods. Patients with heart failure and ICD and patients with newly diagnosed OSAS were divided into two groups according to CPAP treatment. To compare the impact of CPAP on ECG parameters, both baseline and 6-month ECG, 24-hour Holter ECG, ambulatory blood pressure monitoring, echocardiography, polysomnography, and laboratory parameters were collected. Results. CPAP treatment significantly reduced the frequency of premature ventricular contractions, T-peak to T-end, corrected QT, corrected QT dispersion, and T-peak to T-end/corrected QT ratio in the study group (p

Purpose: The aim of this study was to determine the perceptions of patients with atrial fibrillation regarding the disease, to reveal their feelings, thoughts and wishes, and to investigate their perspectives and coping behaviors towards their condition. Methods: Phenomenological methodology was used. The study population consisted of a total of 225 patients treated by the cardiology department of a university hospital, while the study sample consisted of 32 patients who met the inclusion criteria. A semistructured interview addressed perceptions of patients with atrial fibrillation regarding the disease. Data were collected by asking the participants the three questions on the In-depth Individual Interview Form. Data were analyzed using the continuous comparative method of Colaizzi. Results: In the study sample, 50.0% of participants were female, 69.0% were married, and the mean age was 66.90 years (± 7.90 years). As a result of the content analysis, four main themes and 15 subthemes were identified: patient's mental status regarding the disease, patient's social status regarding the disease, patient's physical condition regarding the disease, and disease management and coping with the disease. The study found that individuals with atrial fibrillation faced major limitations in their daily living activities and social lives due to the disease symptoms and warfarin use. Conclusions: Patients need to be provided with relevant individual training and counselling so that they lead more satisfactory lives. In addition, appropriate health appointment and monitoring systems should be developed for patients to reduce the problems associated with frequent follow-up appointments.

Abstract Background Several studies have shown an association of cryptogenic stroke and embolism with patent foramen ovale (PFO), but the question how to prevent further events in such patients is unresolved. Options include antithrombotic treatment with warfarin or antiplatelet agents or surgical or endovascular closure of the PFO. The PC-Trial was set up to compare endovascular closure and best medical treatment for prevention of recurrent events. Methods The PC-Trial is a randomized clinical trial comparing the efficacy of percutaneous closure of the PFO using the Amplatzer PFO occluder with best medical treatment in patients with cryptogenic embolism, i.e. mostly cryptogenic stroke. Warfarin for 6 months followed by antiplatelet agents is recommended as medical treatment. Randomization is stratified according to patients age ( Discussion patients were randomized in 29 centers of Europe, Canada, and Australia. Randomization started February 2000. Enrollment of 414 patients was completed in February 2009. All patients will be followed-up longitudinally. Follow-up is maintained until the last enrolled patient is beyond 2.5 years of follow-up (expected in 2011). Trial Registration Trial listed in ClinicalTrials.gov as NCT00166257 and sponsored by AGA Medical, Plymouth, MN, USA

Abstract Introduction: In the last decade, there has been an increasing use of cartilage grafts in the primary repair of tympanic membrane perforations. The major advantages of cartilage are its stiffness and its very low metabolic requirements, which make it particularly suitable for difficult conditions, such as subtotal perforations, adhesive otitis and reoperation. Objective: To analyze the impact of different perforation sizes requiring different sizes of cartilage on the anatomical and functional outcome after tympanoplasty. Methods: Through this prospective non-controlled, non-randomized study, 50 patients underwent cartilage type 1 tympanoplasty (20 females and 30 males), with a mean age of 19.3 ± 9.8 years. According to size of perforation, patients were subdivided into three groups, Group I had perforation >50% of tympanic membrane area, in Group II patients the perforations were 25-50% of tympanic membrane area, and in Group III the perforations were ≤25% of tympanic membrane. All patients had pre and postoperative Pure Tone Average and Air Bone Gap frequencies (0.5, 1, 2, 4 kHz). All patients were followed up at least 12 months after operation. Results: The anatomical success rate among all patients was 92%, all groups showed statistical significant improvement between pre and postoperative air bone gap, no significant correlation between size of cartilage graft and degree of air bone gap improvement was noticed among the three groups. Conclusion: Size of a cartilage graft has no impact on degree of hearing improvement or anatomical success rate after tympanoplasty.

The harmful impact of waterborne copper (Cu) as a common abiotic stressor in aquatic environments has gained much more interest. The present study aimed to investigate the utilization of zinc oxide nanoparticles (ZnONPs) dietary supplementation to mitigate the chronic toxicity of Cu in African catfish (Clarias gariepinus). Two hundred and forty fish (92.94 ± 0.13 g) were assigned into six groups for 60 days. Control (C), ZnONPs20, and ZnONPs30 groups were fed on basal diets fortified with 0, 20, and 30 mg kg -1 ZnONPs without Cu exposure. Cu, Cu + ZnONPs20, and Cu + ZnONPs30 groups were exposed to Cu at a dose of 10 mg L -1 and fed on basal diets fortified with 0, 20, and 30 mg kg -1 ZnONPs, respectively. The results revealed that the Cu-exposed fish experienced abnormal clinical signs and behavioral changes. The growth indices and acetylcholine esterase activity were significantly decreased (P < 0.05) in the Cu group. Meanwhile, hepatorenal and serum stress indices (P < 0.05) were significantly elevated with chronic Cu exposure. In addition, a higher expression of stress (P < 0.05) (heat shock protein 60 and hypoxia-inducible factor-1 alpha) and apoptotic-related genes (C/EBP homologous protein, caspase-3, and Bcl-2 Associated X-protein) with down-regulation (P < 0.05) of the anti-apoptotic-related genes (B-cell lymphoma 2 and proliferating cell nuclear antigen) was noticed in the Cu-exposed fish. Histopathological alterations in the gills, liver, kidney, and spleen were markedly reported in the Cu-exposed group. The dietary supplementation with ZnONPs significantly alleviated the negative impacts of chronic waterborne-Cu exposure on growth performance, physiological changes, gene expression, and tissue architecture, especially at 30 mg kg -1 diet level. In particular, the inclusion of ZnONPs at the 30 mg kg -1 diet level produced better outcomes than the 20 mg kg -1 diet. Overall, ZnONPs could be added as a feed supplement in the C. gariepinus diet to boost the fish's health and productivity and alleviate the stress condition brought on by Cu exposure., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The present investigation proposed an innovative trial at the probable beneficial effects of nano- Bacillus amyloliquefaciens (NBA) dietary incorporation on the Nile tilapia ( Oreochromis niloticus ). The investigation included the impact on the growth, digestive functions, immune-antioxidant indices, and resistance to Aeromonas hydrophila challenge. A total of 135 fish (35.14 ± 0.12 g) were equally allocated into three groups (45 fish/group; 15 fish/replicate) in triplicates for 70 days. The control, NBA2, and NBA4 groups were fed basal diets enriched with 0, 10 2 , and 10 4  CFU/kg NBA, respectively. Following the feeding experiment, all experimental groups were injected with 0.1 mL (1.5 × 10 6 ) A. hydrophila, and the fish mortalities were observed for 14 days. The outcomes showed that dietary NBA (NBA4 followed by the NBA2 diet) augmented the growth variables (final body weight, total weight gain, and specific growth rate) and condition factor and declined the feed conversion ratio. The intestinal digestive enzyme (amylase and lipase) and growth hormone levels were increased and the serum glucose level was decreased by dietary NBA. Furthermore, NBA diets enhanced the immune (total protein, globulin, lysozyme, complement 3, myeloperoxidase, and phagocytic activity) and antioxidant (superoxide dismutase, catalase, and total antioxidant capacity) parameters. The intestinal histology revealed no pathological lesions with a significant improvement in the intestinal histomorpho-measures (villus height and width, villus surface area, lamina propria thickness, and tunica muscularis thickness) by NBA diets in a dose-dependent manner. In the fish intestine, the B. amyloliquefaciens count was increased in the NBA groups (NBA4 group followed by NBA2 group) with no discernible difference in the total bacterial count. Fish resistance to the A. hydrophila challenge was increased by increasing the survival % in the NBA4 group (91.70 %) followed by the NBA2 group (83.30 %) compared to the control group (70.80 %). Overall, dietary NBA (especially 10 4  CFU/kg diet) could be a promising feed supplement in the Nile tilapia diets for improving their growth, health, and resistance to bacterial challenges., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Hexaflumuron (HEX) insecticide is widely used in agriculture practices to fight crop insects. The toxicological effect of HEX on Nile tilapia (Oreochromis niloticus) was investigated in this study. Two hundred and forty fish (35.50 ± 1.45 g) were divided into six groups in four replicates (40 fish/group; 10 fish/replicate) and were exposed to six distinct HEX concentrations (0, 2, 4, 6, 8, and 10 mg L -1 ) for 96-h. The 96-h lethal concentration 50 (96-h LC 50 ) of HEX was calculated to be 7.19 mg L -1 . The fish exhibited reduced surface and middle swimming, aggressiveness, and tail-spreading behaviors with increasing bottom swimming and resting patterns after HEX exposure. HEX exposure resulted in body bleeding and fin rot. The erythrogram (red blood cell count, hemoglobin, and packed cell volume %) was significantly reduced with increased mean corpuscular volume by HEX exposure. HEX exposure decreased the white blood cells (WBCs) and differential WBC counts. Acute HEX exposure raised 8-hydroxy-2-deoxyguanosine level while lowering brain acetylcholine esterase activity. HEX exposure caused hepato-renal dysfunction and increased stress-related parameters (glucose and cortisol). Exposure to HEX reduced the immune responses (lysozyme, nitric oxide, immunoglobulin M, and complement 3). A substantial decrease in the antioxidant variables (reduced glutathione content and catalase) with increasing the malondialdehyde was noted by HEX exposure. Moreover, histopathological changes resulted from HEX exposure in the gills, liver, kidney, and spleen. These results indicate that HEX exposure induced behavioral changes, hepato-renal dysfunction, and immune-antioxidant disruption, indicating a possible physiological disruption in O. niloticus., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Bacterial pathogens cause high fish mortalities and in turn economic losses in fish farms. Innovative strategies should be applied to control bacterial infections instead of antibiotics to avoid the resistance problem. Consequently, the present investigation studied the curative potential of Azadirachta indica leave ethanolic extract (AILEE) on Aeromonas veronii infection in Oreochromis niloticus. A preliminary trial was assessed to evaluate the curative dose of AILEE which was found to be 2.5 mg/L. One hundred and sixty fish were divided into equal four groups in four replications, where group 1 and group 2 were non-challenged and treated with 0- and 2.5-mg/L AILEE, respectively. Group 3 and group 4 were challenged with A. veronii and treated with 0- and 2.5-mg/L AILEE, respectively for 10 days. A. veronii infection produced severe clinical manifestations and a high mortality rate in the infected fish. Furthermore, the infected fish exhibited a significant rise in the hepatorenal indices (aspartate aminotransferase, alanine aminotransferase, and creatinine), the oxidant biomarker (malondialdehyde), and the stress indicators (glucose and cortisol). A significant reduction in the protein profile and antioxidant/immune parameters (catalase, immunoglobulin M, lysozyme, nitric oxide, and phagocytic activity) was observed in the infected fish. Water application of the infected group to 2.5-mg/L AILEE notably ameliorated the hepatorenal indices, the oxidant biomarker, and the stress indicators. Furthermore, AILEE improved the antioxidant/immune indices. Water application of 2.5-mg/L AILEE could be useful against A. veronii infection in O. niloticus culture., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Bacterial illness causes detrimental impacts on fish health and survival and finally economic losses for the aquaculture industry. Antibiotic medication causes microbial resistance, so alternative control strategies should be applied. In this work, we investigated the probiotic-medicated diet as an alternative control approach for antibiotics in treating Vibrio cholerae infection in Nile tilapia (Oreochromis niloticus). One hundred eighty fish (50 ± 2.5 g Mean ± SD) were allocated into six groups in glass aquariums (96 L) in triplicate for 10 days. Groups 1 (G1), G2, and G 3 were intraperitoneally (IP) injected with 0.5 mL sterilized tryptic soy broth and fed on a basal diet, basal diet contained B. subtilis (BS) (1 × 10 5 CFU/ kg -1 diet), and basal diet contained trimethoprim-sulfamethoxazole (TMP-SMX) (1.5 g/kg -1 diet), respectively. Additionally, G4, G5, and G6 were IP challenged with 0.5 mL of V. cholerae (1.5 × 10 7 CFU) and received the same feeding regime as G 1 to 3, respectively. The results exhibited that the V. cholera-infected fish exhibited skin hemorrhage, fin rot, and the lowest survival (63.33%). Additionally, lowered immune-antioxidant biomarkers (white blood cells count, serum bactericidal activity, phagocytic activity, phagocytic index, and lysozymes) with higher lipid peroxidation marker (malondialdehyde) were consequences of V. cholerae infection. Noteworthy, fish-fed therapeutic diets fortified with BS and TMP-SMX showed a substantial amelioration in the clinical signs and survival. The BS diet significantly improved (P < 0.05) the immune-antioxidant indices of the infected fish compared to the TMP-SMX diet. The current findings supported the use of a BS-enriched diet as an eco-friendly approach for the control of V. cholerae in O. niloticus., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Environmental stressors (such as ammonia) in aquaculture could increase the risk of pathogenicity, posing a more severe threat to farmed fish. The aim of this study was to investigate the effects of ammonia stress on the pathogenicity of Shewanella spp. in Oreochromis niloticus. First, a 96-hour static test was used to determine the median lethal concentration (LC 50 ) of unionized ammonia to Nile tilapia. After 96 h of exposure, the Un-ionized ammonia (UIA) LC 50 was estimated to be 4.26 mg/L. Second, an experiment was conducted to test the effect of unionized ammonia stress on the pathogenicity of Shewanella spp. in O. niloticus for 30 days. A study involved 180 fish divided into six groups, with the first group serving as a control. The second group (AMN1/10) and the third group (AMN1/20) were not challenged and were exposed to 1/10 (0.42 mg/L) and 1/20 (0.21 mg/L) of the 96-hour LC 50 of UIA, respectively. Then 0.2 mL (0.14 × 10 5 ) of Shewanella spp. was intraperitoneally injected into the fourth (SH), fifth (SH + AMN1/10), and sixth (SH + AMN1/20) groups, which were subjected to 0, 1/10 (0.42 mg/L), and 1/20 (0.21 mg/L) of the 96-hour LC 50 of UIA, respectively. The survival rate, hematological indices, immunological parameters, and antioxidant activity of the fish significantly decreased when they were exposed to ammonia and Shewanella infection separately or together. Histopathological changes were also observed in the kidney and liver. Furthermore, both individual and combined exposures significantly altered renal and hepatic function, with notable increases in glucose and cortisol levels, as well as in the expression of proinflammatory cytokine genes (TNF-α and IL-1ß). However, the detrimental effects of co-exposure to ammonia stress and Shewanella infection were greater than those of separate exposures. As a result, we may say that increased ammonia concentrations enhance the infection of Shewanella spp. These findings could contribute to a better understanding of Shewanella infection in Nile tilapia., (© 2024. The Author(s).)

Background: The inappropriate use of pesticides including fungicides creates severe biological hazards that can endanger fish health and impede sustainable aquaculture., Objective: This study investigated the negative impacts of metiram (MET), a fungicide on the health status of Nile tilapia (Oreochromis niloticus) for a 96-hour duration as an acute exposure in a static renewal system., Methods: Three hundred fish (average body weight: 37.50 ± 0.22 g) were assigned into six groups (50 fish/group) with five replicates (10 fish/replicate). Fish were exposed to various six concentrations (0, 1.5, 3, 4.5, 6, and 7.5 mg/L) of MET as a water exposure to for 96-hour without water exchange. The fish's behavior, clinical signs, and mortalities were documented every day of the exposure period. Additionally, MET's impact on blood profile, stress biomarkers, hepato-renal functions, immune-antioxidant status, and brain biomarker were closely monitored., Results: The lethal concentration (LC 50 ) of MET estimated using Finney's probit technique was 3.77 mg/L. The fish's behavior was severely impacted by acute MET exposure, as clear by an increase in surfacing, loss of equilibrium, unusual swimming, laterality, abnormal movement, and a decline in aggressive behaviors. The survivability and hematological indices (white and red blood cell count, differential white blood cell count, hematocrit value, and hemoglobin) were significantly reduced in a concentration-dependent manner following MET exposure. Acute exposure to MET (1.5-7.5 mg/L) incrementally increased stress biomarkers (nor-epinephrine, cortisol, and glucose), lipid peroxides (malondialdehyde), and brain oxidative DNA damage biomarker (8-hydroxy-2-deoxyguanosine). A hepato-renal dysfunction by MET exposure (4.5-7.5 mg/L) was evidenced by the significant increase in the alanine and aspartate aminotransferases and creatinine values. Moreover, a substantial decline in the immune parameters (lysozyme, complement 3, serum bactericidal activity, and antiprotease activity) and antioxidant variables (total antioxidant capacity, superoxide dismutase, and glutathione peroxidase) resulted from acute MET exposure., Conclusion: According to these findings, the 96-hour LC 50 of MET in Nile tilapia was 3.77 mg/L. MET exposure triggered toxicity in Nile tilapia, as seen by alterations in fish neuro-behaviors, immune-antioxidant status, hepato-renal functioning, and signifying physiological disturbances. This study emphasizes the potential ecological dangers provoked by MET as an environmental contaminant to aquatic systems. However, the long-term MET exposure is still needed to be investigated., (© 2024. The Author(s).)

In aquaculture, fluctuating water temperatures can act as a potent stressor, influencing the virulence and transmission dynamics of pathogenic bacteria, potentially triggering outbreaks and impacting fish health. The purpose of this work was to examine the impact of Shewanella spp. infection on hematological, biochemical, and antioxidant-immune parameters of Nile tilapia (Oreochromis niloticus) under different water temperatures. For this purpose, 180 fish were divided into 6 groups in triplicate (30 fish per group; 10 fish per replicate). Group 1 (G1), G2, and G3 were reared at varying water temperatures (22 °C, 28 °C, and 31 °C, respectively) without infection. While G4, G5, and G6 were IP-injected with 0.2 mL of Shewanella spp. (0.14 × 10 5 ) and reared at 22 °C, 28 °C, and 31 °C, respectively. Shewanella spp. infection induced significant lowering (p < 0.05) in hematological parameters (red and white blood cells, hemoglobin, and packed cell volume%) and immune-antioxidant responses (phagocytic activity%, phagocytic index, lysozyme, nitric oxide), total antioxidant capacity, catalase, and reduced glutathione, especially at 22 °C. Moreover, a significant increase (p < 0.05) in the hepato-renal function indicators (alanine aminotransferase, aspartate aminotransferase, urea, and creatinine), stress biomarkers (glucose and cortisol), malondialdehyde, and pro-inflammatory cytokines (interleukin-1β and tumor necrosis factor-α) were the consequences of the Shewanella spp. infection, especially at 22 °C. The Shewanella spp. infection exhibited marked histopathological changes in the hepatic and renal tissues. Worthily, Shewanella spp. can cause detrimental alterations in Nile tilapia's hematological, biochemical, and antioxidant-immune parameters at various water temperatures, but the major detrimental changes were observed at a water temperature of 22 °C. Consequently, we can conclude that the infection dynamics of Shewanella spp. are exaggerated at 22 °C. These outcomes could help in understanding the nature of such an infection in Nile tilapia., Competing Interests: Declaration of competing interest The authors claim there are no competing financial interests in this study., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

This study looked at the toxic impacts of water-born acrylamide (ACR) on Nile tilapia (Oreochromis niloticus) in terms of behaviors, growth, immune/antioxidant parameters and their regulating genes, biochemical indices, tissue architecture, and resistance to Aeromonas hydrophila. As well as the probable ameliorative effect of Chlorella vulgaris (CV) microalgae as a feed additive against ACR exposure was studied. The 96-h lethal concentration 50 of ACR was investigated and found to be 34.67 mg/L for O. niloticus. For the chronic exposure study, a total of 180 healthy O. niloticus (24.33 ± 0.03 g) were allocated into four groups in tri-replicates (15 fish/replicate), C (control) and ACR groups were fed a basal diet and exposed to 0 and 1/10 of 96-h LC 50 of ACR (3.46 mg/L), respectively. ACR+ CV5 and ACR+ CV10 groups were fed basal diets with 5 % and 10 % CV supplements, respectively and exposed to 1/10 of 96-h LC 50 of ACR for 60 days. After the exposure trial (60 days) the experimental groups were challenged with A. hydrophila. The findings demonstrated that ACR exposure induced growth retardation (P˂0.01) (lower final body weight, body weight gain, specific growth rate, feed intake, protein efficiency ratio, final body length, and condition factor as well as higher feed conversion ratio). A substantial decrease in the immune/antioxidant parameters (P˂0.05) (lysozyme, serum bactericidal activity %, superoxide dismutase, and reduced glutathione) and neurotransmitter (acetylcholine esterase) (P˂0.01) was noticed with ACR exposure. A substantial increase (P˂0.01) in the serum levels of hepato-renal indicators, lipid peroxidation biomarker, and cortisol was noticed as a result of ACR exposure. ACR exposure resulted in up-regulation (P˂0.05) of the pro-inflammatory cytokines and down-regulation (P˂0.05) of the antioxidant-related gene expression. Furthermore, the hepatic, renal, brain, and splenic tissues were badly affected by ACR exposure. ACR-exposed fish were more sensitive to A. hydrophila infection and recorded the lowest survival rate (P˂0.01). Feeding the ACR-exposed fish with CV diets significantly improved the growth and immune/antioxidant status, as well as modulating the hepatorenal functions, stress, and neurotransmitter level compared to the exposed-non fed fish. In addition, modulation of the pro-inflammatory and antioxidant-related gene expression was noticed by CV supplementation. Dietary CV improved the tissue architecture and increased the resistance to A. hydrophila challenge in the ACR-exposed fish. Noteworthy, the inclusion of 10 % CV produced better results than 5 %. Overall, CV diets could be added as a feed supplement in the O. niloticus diet to boost the fish's health, productivity, and resistance to A. hydrophila challenge during ACR exposure., Competing Interests: Declaration of competing interest The author declares no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The red pepper (Capsicum annuum) has gained great attention recently because of its biological and pharmacological characteristics. The present approach aimed to evaluate the effects of C. annuum alcoholic extract (CAE) supplementation on Nile tilapia (Oreochromis niloticus) growth performance, physiological status, some metabolic, immune, and regulatory genes expression, and resistance against Streptococcus agalactiae infection. Fish (22.26 ± 0.19 g) were assigned to four treatments (five replicates, each with 10 fish replicate -1 ) and fed tested diets for 60 days. The experimental diets were supplemented with CAE at 0, 0.4, 0.8, and 1.6 g kg -1 , expressed as CAE0, CAE0.4, CAE0.8, and CAE1.6, respectively. The findings exhibited that CAE dietary supplementation improved growth performance, feed utilization, elevated growth hormone level, and digestive enzyme activities (amylase and protease), and lowered leptin hormone in a level-dependent manner. Boosting the mRNA expression of the transporter proteins (solute carrier family 15 member 2 and solute carrier family 26 member 6) and insulin-like growth factor-1 genes with a decrease in the myostatin gene expression was noticed in the CAE-fed groups. The innate immune (serum bactericidal activity %, complement 3, and phagocytic activity %) and antioxidant (glutathione peroxidase and total antioxidant capacity) parameters were significantly (p < 0.05) improved, and the serum malondialdehyde level was significantly decreased by CAE dietary inclusion. A marked upregulation in the mRNA expression of interleukins (il-1β, il-6, il-8, and il-10), transforming growth factor-β, glutathione peroxidase, and glutathione synthetase genes were observed in CAE-fed groups. Dietary CAE decreased the cumulative mortalities after the challenge with S. agalactiae by 20, 13.33, and 10% in CAE0.4, CAE0.8, and CAE1.6, respectively, compared to the control (40%). Overall, dietary supplementation with CAE could improve growth performance and physiological status, and modulate the expression of several regulatory genes in Nile tilapia. The recommended level of CAE is 1.6 g kg -1 to augment growth and health status., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Inc.)

Bacterial infection is considered one of the major issues in fish culturing that results in economic losses. Metal nanoparticles are a cutting-edge and effective disease management and preventive strategy because of their antibacterial ability. In this investigation, the selenium nanoparticles were prepared by a biological method using Nelumbo nucifera leaves extract. The in-vitro antibacterial activity of N. nucifera synthesized selenium nanoparticles (NN-SeNPs) was tested against Aeromonas veronii. A treatment assay was conducted on 210 Oreochromis niloticus (average body weight: 27 ± 2.00 g). A preliminary approach was conducted on 90 fish for determination of the therapeutic concentration of NN-SeNPs which was found to be 4 mg/L. Fish (n = 120) were categorized into four groups for 10 days; G 1 (control) and G 2 (NN-SeNPs) were non-challenged and treated with 0 and 4 mg/L NN-SeNPs, respectively. While, G 3 and G 4 were infected with 2 × 10 6  CFU/mL of A. veronii and treated with 0 and 4 mg/L NN-SeNPs, respectively. NN-SeNPs exhibited an inhibition zone against A. veronii with a diameter of 16 ± 1.25 mm. The A. veronii infection increased the hepato-renal biomarkers (alanine and aspartate aminotransferases and creatinine) than the control group. An oxidative stress was the consequence of A. veronii infection (higher malondialdehyde and hydrogen peroxide levels with lower glutathione peroxidase superoxide, dismutase, and catalase activity). A. veronii infection resulted in lower immunological biomarker values (immunoglobulin M, lysozyme, and complement 3) with higher expression of the inflammatory cytokines (interleukin-1β and tumor necrosis factor-ɑ) as well as lower expression of the anti-inflammatory cytokines (interleukin-10 and transforming growth factor-β). Therapeutic application with 4 mg/L NN-SeNPs prevented the disease progression; and modulated the hepato-renal function disruptions, oxidant-immune dysfunction, as well as the pro/anti-inflammatory cytokines pathway in the A. veronii-infected fish. These findings suggest that NN-SeNPs, employed as a water therapy, can safeguard fish from the harmful effects of A. veronii and serve as a promising antibacterial agent for sustainable aquaculture., Competing Interests: Declaration of competing interest The authors claim that there is no any conflict of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

This study was established to look into the toxicological consequences of chronic exposure to a fungicide (mancozeb; MAZ) on the immune-antioxidant response, gene expressions, hepato-renal functions, and histological pictures of Nile tilapia (Oreochromis niloticus). Additionally, the effectiveness of Indian frankincense resin extract (IFRE) to mitigate their toxicity was taken into account. Fish (n =240; average body weight: 22.45 ± 2.21 g) were randomized into four groups for eight weeks in six replicates (control, IFRE, MAZ, and IFRE + MAZ), where ten fish were kept per replicate. The control and IFRE groups received basal diets that included 0.0 and 5 g/kg of IFRE without MAZ exposure. The MAZ and IFRE+MAZ groups received the same diets and were exposed to 1/10 of the 96-h of LC 50 of MAZ (1.15 mg/L). The outcomes displayed that MAZ exposure resulted in a lower survival rate (56.67 %) and significantly decreased levels of immune-antioxidant variables (antiprotease, complement3, phagocytic activity, lysozyme, glutathione peroxidase, superoxide dismutase, and total antioxidant capacity) compared to the control group. The MAZ-exposed fish showed the greatest levels of lipid peroxide (malondialdehyde), alkaline phosphatase, alanine amino-transferase, and stress indicators (cortisol and glucose). Additionally, histopathological alterations, including vacuolation, severe necrosis, degeneration, and mononuclear cell infiltrations in the hepatic, renal, and splenic tissues resulted, besides a reduction in the melanomacrophage center in the spleen. A down-regulation of immune-antioxidant-associated genes [toll-like receptors (TLR-2 and TLR-7), nuclear factor kappa beta (NF-κβ), transforming growth factor-beta (TGF-β), phosphoinositide-3-kinase regulatory subunit 3 gamma b (pik3r3b), interleukins (IL-1β and IL-8), glutathione synthetase (GSS), glutathione peroxidase (GPx), and superoxide dismutase (SOD)] were the consequences of the MAZ exposure. Remarkably, the dietary inclusion of IFRE in MAZ-exposed fish augmented the immune-antioxidant parameters, including their associated genes, decreased stress response, and increased survival rate (85 %) compared with the MAZ-exposed fish. Moreover, dietary IFRE improved hepato-renal function indices by preserving the histological architecture of the hepatic, renal, and splenic tissues. The insights of this study advocate the use of an IFRE-dietary addition to protect Nile tilapia from MAZ toxicity, which provides perspectives for future implementations in enhancing fish health for sustainable aquaculture., Competing Interests: Declaration of Competing Interest The authors claim that there is no conflict of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

A feeding trial for 90 days was conducted on Nile tilapia (Oreochromis niloticus) (average weight: 25.50 ± 0.05 g) to evaluate the effect of dietary inclusion of Azadirachta indica seed protein hydrolysate (AIPH). The evaluation included the impact on the growth metrics, economic efficiency, antioxidant potential, hemato-biochemical indices, immune response, and histological architectures. A total of 250 fish were randomly distributed in five treatments (n = 50) and received diets included with five levels of AIPH (%): 0 (control diet, AIPH0), 2 (AIPH2), 4 (AIPH4), 6 (AIPH6) or 8 (AIPH8), where AIPH partially replace fish meal by 0, 8.7%, 17.4%, 26.1%, and 34.8%, respectively. After the feeding trial, a pathogenic bacterium (Streptococcus agalactiae, 1.5 × 10 8 CFU/mL) was intraperitoneally injected into the fish and the survival rate was recorded. The results elucidated that AIPH-included diets significantly (p < 0.05) enhanced the growth indices (final body weight, total feed intake, total body weight gain, and specific growth rate) and intestinal morpho-metrics (villous width, length, muscular coat thickness, and goblet cells count) in comparison to the control diet, with the AIPH8 diet recording the highest values. Dietary AIPH inclusion significantly improved (p < 0.05) the economic efficacy indicated by reduced feed cost/kg gain and increased performance index. The fish fed on the AIPH diets had noticeably significantly higher (p < 0.05) protein profile variables (total proteins and globulin) and antioxidant capabilities (superoxide dismutase and total antioxidant capacity) than the AIPH0 group. The dietary inclusion of AIPH significantly (p < 0.05) boosted the haematological parameters (haemoglobin, packed cell volume %, and counts of red blood cells and white blood cells) and immune indices (serum bactericidal activity %, antiprotease activity, and immunoglobulin M level) in a concentration-dependent manner. The blood glucose and malondialdehyde levels were significantly (p < 0.05) lowered by dietary AIPH (2%-8%). The albumin level and hepatorenal functioning parameters (aspartate aminotransferase, alanine aminotransferase, and creatinine) were not significantly (p > 0.05) altered by AIPH diets. Additionally, AIPH diets did not adversely alter the histology of the hepatic, renal or splenic tissues with moderately activated melano-macrophage centres. The mortality rate among S. agalactiae-infected fish declined as dietary AIPH levels rose, where the highest survival rate (86.67%) was found in the AIPH8 group (p < 0.05). Based on the broken line regression model, our study suggests using dietary AIPH at the optimal level of 6%. Overall, dietary AIPH inclusion enhanced the growth rate, economic efficiency, health status, and resistance of Nile tilapia to the S. agalactiae challenge. These beneficial impacts can help the aquaculture sector to be more sustainable., (© 2023 Wiley-VCH GmbH. Published by John Wiley & Sons Ltd.)

Finding eco-friendly alternatives for antibiotics in treating bacterial diseases affecting the aquaculture sector is essential. Herbal plants are promising alternatives, especially when combined with nanomaterials. Neem ( Azadirachta indica ) leaves extract was synthesized using a chitosan nanocapsule. Chitosan neem nanocapsule (CNNC) was tested in- vitro and in- vivo against the Aeromonas sobria ( A. sobria ) challenge in Nile tilapia. A preliminary experiment with 120 Nile tilapia was conducted to determine the therapeutic dose of CNNC, which was established to be 1 mg/L. A treatment study was applied for seven days using 200 fish categorized into four groups (10 fish/replicate: 50 fish/group). The first (control) and second (CNNC) groups were treated with 0 and 1 mg/L CNNC in water without being challenged. The third ( A. sobria ) and fourth (CNNC +  A. sobria ) groups were treated with 0 and 1 mg/L CNNC, respectively, and challenged with A. sobria (1 × 10 7  CFU/mL). Interestingly, CNNC had an in- vitro antibacterial activity against A. sobria ; the minimum inhibitory concentration and minimum bactericidal concentration of CNNC against A. sobria were 6.25 and 12.5 mg/mL, respectively. A. sobria challenge caused behavioral alterations, skin hemorrhage, fin rot, and reduced survivability (60%). The infected fish suffered a noticeable elevation in the malondialdehyde level and hepato-renal function markers (aspartate aminotransferase, alanine aminotransferase, and creatinine). Moreover, a clear depletion in the level of the antioxidant and immune indicators (catalase, reduced glutathione, lysozymes, nitric oxide, and complement 3) was obvious in the A. sobria group. Treatment of the A. sobria- challenged fish with 1 mg/L CNNC recovered these parameters and enhanced fish survivability. Overall, CNNC can be used as a new versatile tool at 1 mg/L as a water treatment for combating the A. sobria challenge for sustainable aquaculture production., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

An acute exposure study of mancozeb (MAZ) fungicide was applied on Oreochromis niloticus for 96-h duration. Three hundred fish (20.50 ± 1.60 g) were assigned into six groups (50 fish/ group; 10 fish/replicate) and exposed to different six concentrations (0, 4, 8, 12, 16, and 20 mg L -1 ) of MAZ for 96-h. The Probit analysis program was used to compute the 96-h lethal concentration 50 (96-h LC 50 ) of MAZ. During the exposure duration, the fish's behavior, clinical symptoms, and mortalities were recorded daily. After the exposure period was ended, the hematological, biochemical, immunological, and oxidant/antioxidant parameters were evaluated. The results of this study recorded the 96-h LC 50 of MAZ for O. niloticus to be 11.49 mg L -1 . Acute MAZ exposure badly affected the fish's behavior in the form of increased the breath gasping and swimming activity with aggressive mode. The exposed fish showed excessive body hemorrhages and fin rot. The survival rate of the exposed fish to MAZ was 100, 80, 66, 50, 38, and 30% in 0, 4, 8, 12, 16, and 20 mg L -1 MAZ, respectively. The hematological indices (red blood cell count, hemoglobin, packed cell volume%, and white blood cell count) were significantly decreased by increasing the MAZ exposure concentration (8-20 mg L -1 ). The acetylcholine esterase activity and immune indices (lysozyme, nitric oxide, immunoglobulin M, complement 3) were decreased by MAZ exposure (4-20 mg L -1 ). Acute MAZ exposure induced hepato-renal dysfunction and elevated stress-related parameter (cortisol) by increasing the MAZ concentration. A significant reduction in the antioxidant parameters (total antioxidant activity, catalase, and superoxide dismutase) with increasing the lipid peroxidation marker (malondialdehyde) was noticed by acute MAZ exposure (4 -20 mg L -1 ) in O. niloticus. Based on these outcomes, the MAZ exposure induced toxicity to the fish evident in changes in fish behavior, neurological activity, hepato-renal functioning, and immune-antioxidant responses which suggest physiological disruption., Competing Interests: Declaration of Competing Interest The authors claim that there is no any conflict of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Thromboembolism was a chief cause of mortality in 70% of patients with COVID-19. Our objective was to see if serum interleukins 1 beta (IL-1β) and soluble platelets selectin (sP-selectin) could serve as novel markers of thromboembolism in COVID-19 patients., Methods: This cross sectional study involved 89 COVID-19 patients who were recruited from 1st of February to 1st of May 2021. Clinical and laboratory data were collected, and chest imaging was performed. The levels of IL-1β and sP-selectin were assessed in all cases through ELISA kits. Comparisons between groups were done using an unpaired t-test in normally distributed quantitative variables. In contrast, a non-parametric Mann-Whitney test was used for non-normally distributed quantitative variables., Results: Severe COVID-19 infection was associated with higher serum levels of CRP, Ferritin, LDH, D dimer, IL-1β and sP-selectin (P <  0.001) with significant correlation between levels of IL-1β and sP-selectin (r 0.37, P <  0.001), D-dimer (r 0.29, P 0.006) and Ferritin (r 0.5, p <  0.001). Likewise, a positive correlation was also found between levels of sP-selectin, D-dimer and Ferritin (r 0.52, P <  0.001) (r 0.59, P <  0.001). Imaging studies revealed that 9 (10.1%) patients developed venous and 14 (15.7%) developed arterial thrombosis despite receiving anticoagulant therapy. Patients with thrombotic events had significantly higher levels of IL-1β, sP-selectin and LDH serum levels. Meanwhile, there was no statistical significance between CRP, D-dimer or Ferritin levels and the development of thrombotic events., Conclusion: IL-1β and sP-selectin levels can be promising predictors for severe COVID-19 infection and predictable thrombosis., (© 2022. The Author(s).)

Two experiments were conducted in this study, using 250 Oreochromis niloticus (O. niloticus) (average weight 30.28 ± 0.27 g). The first experiment was conducted to investigate the 96-h lethal concentration 50 (LC 50 ) of copper chloride (CuCl 2 ) using the probit analysis, seventy fish was divided into seven different concentration of CuCl 2 (0, 22, 23, 24, 25, 26, and 27 mg/L), the accurate Cu concentrations were (1.23, 5.36, 6.02, 6.98, 7.05, 7.93, 8.12 mg/L Cu). The second experiment was conducted for investigating the effect of dietary supplementation with thyme (Thymus vulgaris, T. vulgaris) and sweet basil (Ocimum basilicum, O. basilicum) essential oils (TEO and BEO respectively) against sub-lethal Cu exposure (1/10 96-h LC 50 of CuCl 2 ). About 180 fish was divided into six groups in triplicate (10 fish/replicate, 30 fish/group). Group 1 (C) was kept as a control group with no Cu exposure and was fed the control basal diet. Group 2 (C-Cu) was fed the control basal diet and simultaneously exposed to 1/10 of the 96 h LC 50 of CuCl 2 (2.574 mg/L) as a sub-lethal concentration of Cu, where the realistic Cu concentration was 3.976 mg/L. Group 3 (TEO) and group 4 (BEO) were fed the diets fortified with 1%TEO and BEO, respectively without exposure to Cu. Group 5 (TEO-Cu) and group 6 (BEO-Cu) were fed the diets fortified with 1%TEO and 1%BEO, respectively, and simultaneously exposed to 1/10 of the 96 h LC 50 of CuCl 2 (2.574 mg/L). The growth and behavioral performance, immunological response and its related gene expression, antioxidant status, stress biomarker indicators, apoptosis biomarkers, and histopathological alteration were investigated. The results of the first experiment showed that the 96-h LC 50 of CuCl 2 in O. niloticus was 25.740 mg/L with lower and upper confidence limits of 25.152 and 26.356 mg/L, respectively. The results of the second experiment showed that sub-lethal Cu exposure induced growth retardation (lowered final body weight, total weight gain, and specific growth rate %), behavioral abnormalities (slower swimming activity and feeding performance), immunosuppression (lowered nitric oxide, complement-3, lysozyme, total proteins, albumin, and globulin), and lowering the hepatic antioxidant functions (higher MDA, and lower SOD, CAT, and GPx) in the exposed fish. Furthermore, alteration in the immune-related genes expression (down-regulation of IL-10 and TGF-β and up-regulation of IL-1β, IL-6, IL-8, and TRL-4), hepato-renal dysfunction (elevated ALT, AST, urea, and creatinine), and high levels of serum stress indicators (cortisol and glucose) were markedly evident. sub-lethal Cu toxicity induced significant up-regulation of apoptosis biomarkers involving, nuclear factor-κβ (NF-κβ), Bcl-2 Associated X-protein (BAX), meanwhile, the expression of B-cell lymphoma 2 (BCL2) and Proliferating cell nuclear antigen (PCNA) was remarkably down-regulated. In addition, apoptosis was also evident by histopathological investigation of branchial, hepatic, and renal sections. TEO and/or BEO dietary supplementation mitigate the destructive impacts of sub-lethal Cu exposure in O. niloticus, depending on the results of our study, it could be concluded that TEO and BEO with a 1% dietary level could be a promising antioxidant, immunostimulant, anti-stress factors, and anti-apoptosis mediators against heavy metal contaminants (Cu) in O. niloticus, providing a solution to the problem of aquatic bodies pollution, consequently aiding in the development of aquaculture industry., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The present study evaluated the potential effects of dietary inclusion of spray-dried bovine hemoglobin powder (SDBH) on the growth, gene expression of peptide and amino acid transporters, insulin growth factor-1 ( IGF-1 ) and myostatin , digestive enzymes activity, intestinal histomorphology and immune status, immune-related gene expression, and economic efficiency in Nile tilapia, Oreochromis niloticus . Two hundred twenty-five fingerlings (32.38 ± 0.05 g/fish) were distributed into five treatments with five dietary inclusion levels of SDBH: 0, 2.5, 5, 7.5, and 10% for a ten-week feeding period. Dietary inclusion of SDBH linearly increased the final body weight (FBW), total weight gain (TWG), specific growth rate (SGR), and protein efficiency ratio (PER). Additionally, a linear decrease in feed conversion ratio (FCR) and daily feed intake relative to the daily BW was reported in the highest inclusion levels (7.5 and 10%). Dietary inclusion of SDBH was associated with a significant increase in the intestinal villous height (VH), villous width (VW), villous height: crypt depth ratio (VH: CD), and muscle coat thickness (MCT), with the highest values reported in SDBH7.5 group. Increased serum growth hormone levels and decreased serum leptin hormone levels were also reported by increasing the SDBH level. The serum glucose level was decreased in the SDBH7.5 and SDBH10 groups. The digestive enzymes' activity (amylase and protease) was increased by increasing the SDBH inclusion level. An up-regulation in the expression of peptide and amino acid transporters, IGF-1, and down-regulation of myostatin was reported in the SDBH2.5 to SDBH7.5 groups. Spleen sections showed more lymphoid elements, especially in the SDBH2.5 and SDBH7.5 groups. The SDBH inclusion increased the serum lysozyme activity, nitric oxide (NO), and complement 3 (C3) levels, with the highest values recorded in the SDBH5 group. The phagocytic % and the phagocytic index were increased by increasing the SDBH inclusion %. The expressions of immune-related genes (transforming growth factor-beta ( TGF-β ), Toll-like receptor 2 ( TLR2 ), and interleukin 10 ( IL10 )) were up-regulated by SDBH inclusion with the highest expression in the SDBH5 group. Economically, the feed costs and feed costs/kg gain were linearly decreased in the SDBH7.5 and SDBH10 diets. In conclusion, spray-dried bovine hemoglobin powder could be used as a protein source for up to 10% of the diets of Nile tilapia for better growth and immune status of fish.

Several studies have looked into the use of basil, Ocimum basilicum (L.) in aquaculture as a dietary additive; however, more research is needed to see the possibility of it's including in nanocarriers in aquafeeds. An experiment was undertaken to highlight the efficacy chitosan-Ocimum basilicum nanocomposite (COBN), for the first time, on Nile tilapia (Oreochromis niloticus) growth, stress and antioxidant status, immune-related parameters, and gene expression. For 60 days, fish (average weight: 23.55 ± 0.08 g) were fed diets provided with different concentrations of COBN (g/kg): 0 g [COBN0], 1 g [COBN1], 2 g [COBN2], and 3 g [COBN3], where COBN0 was kept as control diet. Following the trial, the fish were challenged with pathogenic bacteria (Aeromonas sobria) and yeast (Candida albicans) infection. In comparison to the control (COBN0), a notable increase in growth parameters (weight gain, feed intake, and specific growth rate) and intestinal morphometric indices (average intestinal goblet cells count, villous width, and length) in all COBN groups was observed, where COBN2 and COBN3 groups had the highest values. The COBN diets significantly (p < 0.05) declined levels of serum triglycerides, glucose, cholesterol, and hepatic malondialdehyde. Moreover, the higher levels of serum biochemical biomarkers (growth hormone, total protein, globulin, and albumin), immunological parameters (phagocytic activity%, nitric oxide, and lysozyme), and hepatic antioxidant parameters (superoxide dismutase, total antioxidant capacity, and glutathione peroxidase) were obvious in the COBN2 and COBN3 groups followed by COBN1. The immune-antioxidant genes (TNF-α, IL-10, IL-1β, TGF-β, GPx, and SOD) were found to be considerably up-regulated in all COBN groups (COBN2 and COBN3 followed by COBN1). Fifteen days post-challenge with A. sobria and C. albicans, the highest survival rate was recorded in the COBN2 group (83.33 and 91.67%) followed by the COBN3 group (75 and 83.33%), respectively. The findings showed that a dietary intervention with COBN can promote growth, intestinal architecture, immunity, and antioxidant markers as well as protect O. niloticus against A. sobria and C. albicans infection. As a result, the COBN at a dose of 2 g/kg could be used as a food additive for the sustainable aquaculture industry., Competing Interests: Declaration of competing interest The authors claim that there is no conflict of interest., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: We aimed to investigate the effect of transforaminal injection of Magnesium sulphate versus Ozone on pain intensity, functional disability and the oxidative stress biomarkers; superoxide dismutase (SOD) and Glutathione (GSH) in patients with lumbar disc prolapse., Methods: This randomized controlled trial was conducted on 135 patients having symptomatic lumbar disc prolapse, received either transforaminal injection of Magnesium sulphate with steroids, Ozone with steroids, or steroids alone. Assessment of pain severity and functional disability were done before intervention, 2 weeks, 1, 3, and 6 months after intervention. Serum SOD and GSH were measured for all included patients before and 2 weeks after intervention., Results: There was a statistically significant improvement in pain intensity and functional disability 2 weeks after intervention in the three groups, but at 1-month and 3-months after intervention, the significant improvement was in Mg sulphate and Ozone groups only. At 6-months follow up, Mg sulphate group only showed a significant improvement. There was a statistically significant increase in SOD and GSH serum levels, 2-weeks after intervention in both Magnesium sulphate (P-value = 0.002, 0.005 respectively) and ozone groups (P-value < 0.001, < 0.001), but there was no statistically significant change in SOD and GSH serum levels in control group., Conclusion: Transforaminal injection of Mg sulphate in patients with lumbar disc prolapse causes significant long-term improvement (up to 6 months) in pain intensity and functional disability. The serum levels of SOD and GSH were significantly increased at 2 weeks following both transforaminal injection of Mg sulphate and ozone., (© 2022. The Author(s).)

Objectives: To assess risk factors for persistent neuropathic pain in subjects recovered from coronavirus disease 2019 (COVID-19) and to study the serum level of neurofilament light chain (NFL) in those patients., Design: Case-control study., Setting: Persistent post-COVID-19 pain., Subjects: In total, 45 patients with post-COVID-19 pain and another 45 age and sex-matched healthcare workers who recovered from COVID-19 without pain., Methods: The included participants were subjected to medical history taking, screening for depressive disorders, comprehensive neurological examination, and pain evaluation using the Douleur Neuropathique en 4 questions (DN4). All patients who had a score at least 4/10 on DN4 were included. The serum NFL level was measured for both groups at the time of patients' enrollment., Results: The frequency of depression, moderate and severe COVID-19 cases, disease duration and serum ferritin were significantly higher in the cases with post-COVID-19 pain than controls. Binary logistic regression revealed that depression, azithromycin use, moderate and severe COVID-19 increased the odds of post-COVID-19 pain by 4.462, 5.444, 4.901, and 6.276 times, respectively. Cases with post-COVID-19 pain had significantly higher NFL (11.34 ± 9.7, 95% confidence interval [CI]: 8.42-14.25) than control group (7.64 ± 5.40, 95% CI: 6.02-9.27), (P value = .029). Patients with allodynia had significantly higher NFL (14.96 ± 12.41, 95% CI: 8.58-21.35) compared to those without (9.14 ± 6.99, 95% CI: 6.43-11.85) (P value = .05)., Discussion: Depression, azithromycin, and moderate and severe COVID-19 are independent predictors of persistent post-COVID-19 pain. Serum NFL may serve as a potential biomarker for persistent neuropathic pain after COVID-19., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)